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Title: The relative effectiveness of cervical spine manipulation and a nonsteroidal anti-inflammatory drug (Ibuprofen) in the treatment of episodic tension-type headaches
Authors: Legoete, Kgosietsile 
Keywords: Chiropractic;Tension-type headache;NSAIDs;Ibuprofen®
Issue Date: 2010
The 1 year overall prevalence of Episodic Tension-Type Headache (ETTH) is
38.3%; with lifetime prevalence at 46% for TTH. Little literature exists to support the
effectiveness of spinal manipulation in the treatment of ETTH. Therefore aim of this
study was to determine the relative effectiveness of cervical spine manipulation and a
Nonsteroidal Anti-inflammatory drug (NSAID) (Ibuprofen®) in the treatment of ETTH.
Method: This study was a prospective randomised clinical trial with two intervention
groups (N=32, n1=16 and n2=16). The allocation of participants to the two groups was
completed by means of simple randomization. Group one were treated using cervical
spine manipulation. Group two were treated using Ibuprofen. Subjective measurements
included the Numerical Rating Scale 101 Questionnaire (NRS-101), Short Form McGill
Pain Questionnaire (SF-MPQ), CMCC Neck Disability Index (CMCC) and Headache
Diary. A p value <0.05 was considered as statistically significant.
Results: The subjective measurements of the NRS-101, SF-MPQ and CMCC showed a
significant time effect in both treatment groups. Several of the subjective Headaches
Diary outcomes followed this trend with significant time effect in both groups. There was
a significant treatment effect for the NRS-101. Several subject outcomes from the
Headache Diary showed a significant treatment effect in favour of manipulation, namely
frequency and duration of headaches.
Conclusion: The findings in this study have shown that cervical spine manipulation is
more effective than Ibuprofen® for the treatment of ETTH in terms of several subjective
outcomes namely: pain intensity (NRS-101), and the frequency and the duration of
headache per day.
Dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Durban University of Technology, Durban, South Africa, 2010.
Appears in Collections:Theses and dissertations (Health Sciences)

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